Help paying · Medicare negotiated price · pharmacy cost · cycle 2028
Orencia (abatacept): where help paying exists, where Medicare's negotiation stands and what pharmacies pay
CMS has selected Orencia for the 2028 negotiation cycle. The CMS file we read (November 6, 2026) lists its negotiated price as taking effect January 1, 2028 and holds no price for it yet, so this page shows no negotiated price. ClinicalTrials.gov lists 33 recruiting trials that name abatacept.
Every package CMS lists
Packages the CMS file lists for Orencia, with NADAC per unit where the benchmark has one (per unit, as the files state).
| NDC | Product | Unit | CMS price status | NADAC |
|---|---|---|---|---|
| 00003-2187-10 | (name not listed) | n/a | Selected; price takes effect January 1, 2028, not yet published | n/a |
| 00003-2187-13 | (name not listed) | n/a | Selected; price takes effect January 1, 2028, not yet published | n/a |
| 00003-2188-11 | Orencia SC | ML | Selected; price takes effect January 1, 2028, not yet published | $1,468 |
| 00003-2188-51 | Orencia SC | ML | Selected; price takes effect January 1, 2028, not yet published | $1,471 |
| 00003-2814-11 | (name not listed) | n/a | Selected; price takes effect January 1, 2028, not yet published | n/a |
| 00003-2818-11 | (name not listed) | n/a | Selected; price takes effect January 1, 2028, not yet published | n/a |
Medicare Part D spending
CMS's Medicare Part D spending dataset reports gross spending on Orencia of $183.92 million in 2024, across 30,087 claims and 4,112 beneficiaries. CMS's dataset states spending is gross drug cost and does not reflect manufacturers' rebates or other price concessions. Spending is the total paid by Medicare, plans and beneficiaries for the drug's claims, not what a patient pays.
| Year | Gross spending | Claims | Beneficiaries | Average spending per claim |
|---|---|---|---|---|
| 2024 | $183.92 million | 30,087 | 4,112 | $6,113 |
| 2023 | $178.40 million | 29,171 | 4,032 | $6,116 |
| 2022 | $170.83 million | 29,460 | 4,109 | $5,799 |
| 2021 | $168.47 million | 29,820 | 4,269 | $5,649 |
| 2020 | $172.17 million | 31,561 | 4,438 | $5,455 |
Source: CMS Medicare Part D spending by drug (data-year-2024, modified 2026-06-25), read November 7, 2026. CMS dataset page. All manufacturers combined; the figures are a drug-level aggregate of claims and say nothing about a formulary or coverage.
Medicare Part B payment limit
CMS publishes a quarterly payment limit for the HCPCS code that its NDC crosswalk links to Orencia. It is a ceiling for providers who bill Medicare Part B, not a price a patient pays, and a code's presence says nothing about whether Medicare covers a product.
| HCPCS code | Quarter | Payment limit | Per dosage descriptor | Effective | Read |
|---|---|---|---|---|---|
| J0129 | 2026 Q4 | $45.94 | 10 MG | October 1, 2026 through December 31, 2026 | November 7, 2026 |
Source: CMS ASP pricing files (october-2026-medicare-part-b-payment-limit-files-final.zip and the matching NDC-HCPCS crosswalk). CMS ASP pricing files page.
Biosimilar status
- Orencia (abatacept) is a reference product in the FDA Purple Book (BLA 125118, approved December 23, 2005). The Purple Book lists 0 biosimilars and 0 interchangeable products that name it as their reference product.
This is what the FDA Purple Book lists on the read date. It is a record, not a forecast of when any product will launch or be substituted.
Source: FDA Purple Book (purplebook-2026-10), read November 7, 2026. Purple Book data file.
Rare-disease (orphan) designations
The FDA's orphan drug database lists 4 designations for Abatacept; abatacept, 1 with an approval recorded. A designation is not an approval and not a statement that the drug treats the condition; the status column is the database's own.
| Designated | Designated use | Status | Sponsor |
|---|---|---|---|
| December 26, 2017 | Prevention of graft versus host disease | Designated/Approved | Bristol-Myers Squibb Co. |
| February 22, 2017 | Treatment of giant cell arteritis | Designated | Bristol-Myers Squibb Research & Development |
| February 22, 2017 | Treatment of idiopathic inflammatory myopathy (IIM) | Designated | Bristol-Myers Squibb Research & Development |
| May 30, 2013 | Treatment of type 1 diabetes mellitus patients with residual beta cell function | Designated | Orban Biotech LLC |
Source: FDA Orphan Drug Designations and Approvals database, read November 7, 2026. FDA orphan drug search.
Medicaid use by state
CMS's State Drug Utilization Data records, for 2025, how many prescriptions each state's Medicaid program paid for under this drug's packages and what it reimbursed. The 5 states with the largest reimbursement are shown. Reimbursement is before the rebates manufacturers pay states, so it is not a net cost and not a price a patient pays.
| State | Medicaid-paid prescriptions | Medicaid reimbursed | Covers |
|---|---|---|---|
| MN | 783 | $2,353,641 | All record types |
| NV | 200 | $999,191 | All record types |
| UT | 105 | $630,160 | Fee-for-service only |
| KY | 116 | $405,743 | Fee-for-service only |
| WV | 63 | $153,158 | All record types |
Where the publisher suppresses small managed-care cells, a state's figure covers fee-for-service claims only and understates use (2 state and package figures are marked that way here). A state missing from the table means its figures were suppressed or not reported, not zero use. 116 older-year figures are held and left out of the table.
Source: CMS State Drug Utilization Data (State Drug Utilization Data 2025, modified 2026-07-13T15:28:32Z), read November 7, 2026. CMS dataset page. State-reported data compiled by CMS; aggregate by state and package, no provider or patient data.
Where help paying exists
No program in our finder currently lists this drug as open to new patients.
Label changes
The FDA file lists no non-manufacturing label change for these applications since November 11, 2025. The most recent one it lists is dated May 29, 2024 (Labeling).
Source: FDA Drugs@FDA data file, read November 7, 2026. Dates are the FDA action dates; the documents are on FDA's own site. FDA data file. All recent changes across these drugs: label changes feed.
Clinical trials recruiting
ClinicalTrials.gov lists 33 interventional trials that name abatacept and are recruiting, and 1 more not yet recruiting. By phase: Phase 2: 12, Phase 3: 7, PHASE1/PHASE2: 6, Phase 1: 3, Phase 4: 2, PHASE2/PHASE3: 2, Early phase 1: 1. The 10 most recently updated are below. A listing is not an offer of free drug and not medical advice. Whether a trial fits is decided by the study team and your own clinician.
| Trial | Title and conditions | Phase | Lead sponsor | Last updated | Countries |
|---|---|---|---|---|---|
| NCT06731504 | HMCT/CT2401: Abatacept GVHD Prophylaxis Following Omidubicel HCTHematologic Malignancy | Early phase 1 | Duke University | November 6, 2026 | United States |
| NCT07675174 | PTCy, Bortezomib and Sitagliptin for Prevention of GvHD Following Allogeneic HSCTGVHD - Graft-Versus-Host Disease | Phase 1 / Phase 2 | Northwell Health | November 6, 2026 | United States |
| NCT06918990 | Treatment of Antibody-Mediated Rejection (ABMR) With CarBelKidney Transplant Rejection | Phase 1 | National Institute of Allergy and Infectious Diseases (NIAID) | October 23, 2026 | United States |
| NCT06055608 | Advancing Transplantation Outcomes in ChildrenKidney Transplant | Phase 2 | National Institute of Allergy and Infectious Diseases (NIAID) | October 23, 2026 | United States, Canada |
| NCT06654882 | Trial of Sequential Medications AfteR TNFi Failure in Juvenile Idiopathic ArthritisPolyarticular Course Juvenile Idiopathic Arthritis (JIA) | Phase 3 | Duke University | October 21, 2026 | United States, Germany, Italy and 1 more |
| NCT07388563 | Azacitidine and Abatacept in Relapsed or Refractory T-Cell LymphomaLymphoma, T Cell, Peripheral; T-cell Lymphoma; Angioimmunoblastic T-cell Lymphoma | Phase 1 | National Cancer Institute (NCI) | October 20, 2026 | United States |
| NCT07599176 | Partial Stem Cell Transplant for Sickle Cell Disease From Matched DonorsSickle Cell Disease; Beta-thalassemia | Phase 1 / Phase 2 | National Heart, Lung, and Blood Institute (NHLBI) | October 13, 2026 | United States |
| NCT06478017 | Belatacept in Heart TransplantationHeart Transplant | Phase 2 | National Institute of Allergy and Infectious Diseases (NIAID) | October 9, 2026 | United States |
| NCT04692493 | RA-PRO PRAGMATIC TRIALRheumatoid Arthritis | Phase 3 | University of Alabama at Birmingham | September 24, 2026 | United States, Canada |
| NCT00920972 | Campath/Fludarabine/Melphalan Transplant Conditioning for Non-Malignant DiseasesMetabolic Disorders; Hematologic, Immune, or Bone Marrow Disorders; Hemoglobinopathies | Phase 1 / Phase 2 | Washington University School of Medicine | September 16, 2026 | United States, Canada |
Source: ClinicalTrials.gov, registry data processed November 6, 2026, summarized and trimmed by OmniRx. Search on ClinicalTrials.gov.
Questions
What is the Medicare negotiated price of Orencia?
CMS has selected Orencia for the 2028 negotiation cycle. The CMS file we read (November 6, 2026) lists its negotiated price as taking effect January 1, 2028 and holds no price for it yet, so this page shows no negotiated price. When CMS publishes a price it will be a Medicare Part D price agreed with the manufacturer, not what a person pays at the counter.
How does the negotiated price compare with what pharmacies pay?
No negotiated price is published yet, so there is nothing to compare with the pharmacy acquisition benchmark.
Is there help paying for Orencia?
No program in our finder lists this drug yet.
Can I join a clinical trial for Orencia?
ClinicalTrials.gov lists 33 recruiting interventional trials that name abatacept (registry data processed November 6, 2026). A listing is not an offer of free drug and not medical advice. Whether a trial fits is decided by the study team and your own clinician.
How much does Medicare Part D spend on Orencia?
CMS's Medicare Part D spending dataset reports gross spending on Orencia of $183.92 million in 2024, across 30,087 claims and 4,112 beneficiaries. CMS's dataset states spending is gross drug cost and does not reflect manufacturers' rebates or other price concessions. Spending is the total paid by Medicare, plans and beneficiaries for the drug's claims, not what a patient pays.
For developers: this drug as data
One call returns price, generic-entry upper bound, label history, recalls, trials, assistance, and where facts exist the FDA safety program (REMS), DEA schedule, orphan designations, safety notices and Medicaid use by state, each with receipts.
Example file: https://omnirx.org/api/v1/dossier/orencia.json
The licence page sets out what a data licence covers, and the API page documents these files.
Evaluation files with receipts; contract may change; not clinical advice.
Sources and terms. CMS Medicare Drug Price Negotiation Program data file (read November 6, 2026; the CMS page states no licence or restriction); CMS NADAC from data.medicaid.gov under the labels in the OmniRx licence ledger; program details read from each program's own pages; CMS Medicare Part D spending by drug; CMS ASP pricing files; FDA Purple Book; FDA Drugs@FDA and Orange Book data files; ClinicalTrials.gov registry data. Figures are stored with their sources in the OmniRx library (edition 2026-11). Free to cite with attribution. Not medical, legal or financial advice. Report an error through the contact page. Licence the data.